Acetarsol Pessaries in the Treatment of Metronidazole Resistant Trichomonas Vaginalis

@article{Chen1999AcetarsolPI,
  title={Acetarsol Pessaries in the Treatment of Metronidazole Resistant Trichomonas Vaginalis},
  author={M. Y. Chen and N. A. Smith and Emma Fox and James S. Bingham and David Barlow},
  journal={International Journal of STD \& AIDS},
  year={1999},
  volume={10},
  pages={277 - 280}
}
In 1960 metronidazole was shown to be the ® rst effective systemic treatment for Trichomonas vaginalis1. As most previous treatments were topical and largely ineffective, its introduction was a signi® cant development2. Since then metronidazole has remained the standard antimicrobial agent for the treatment of trichomonal infections. The ® rst published reports of metronidazole resistant organisms emerged in the late 1970s and early 1980s and, although well established now, the existence of… 
Management of metronidazole-resistant Trichomonas vaginalis – a new approach
TLDR
The combination of tinidazole, a broad-spectrum antibiotic, and clotrimazole pessaries to be a tolerable and effective treatment for metronidazoles-resistant Trichomonas vaginalis.
Management of trichomonas vaginalis in women with suspected metronidazole hypersensitivity.
TLDR
Metronidazole desensitization was effective in the management of women with nitroimidazoles hypersensitivity, and five of 17 infections were eradicated.
Diagnosis and Treatment of Metronidazole-Resistant Trichomonas vaginalis Infection
TLDR
T. vaginalis infections not responding to 5-nitroimidazole drugs used for standard therapy is a concern for adult sexual health due to persistence of infection and its complications as well as the risk for increased spread of disease due to clinical symptom relief following treatment without microbiological cure.
Drug resistance in the sexually transmitted protozoan Trichomonas vaginalis
TLDR
Drug resistance incidence in T. vaginalis appears to be on the increase and improved surveillance of treatment failures is urged, with cross-resistance among the family of 5-nitroimidazole drugs common.
Persistent and recurrent Trichomonas vaginalis infections: epidemiology, treatment and management considerations
TLDR
Most TV isolates from women with treatment failures that have been analyzed for susceptibility testing in the United States have exhibited low-level metronidazole resistance, supporting the initial use of tinidazoles for patients who fail metronIDazole therapy.
In Vitro Study of the Susceptibility of Clinical Isolates of Trichomonas vaginalis to Metronidazole and Secnidazole
TLDR
Ninety-six (96%) of the 100 clinical Trichomonas isolates tested demonstrated lower minimum lethal concentrations for secnidazole than for MTZ, suggesting that secnodazole has better in vitro activity than MTZ.
Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues
TLDR
The origins of repeat positives need further explanation and better treatment options are needed, as high rates of retest positive are found among TV infected persons after single dose MTZ treatment.
Recalcitrant Trichomonas vaginalis infection – a case series
TLDR
An algorithm for treatment of rTV is presented, although clinical trials will be needed to elucidate the best clinical approaches to this problem.
Recalcitrant Trichomonas vaginalis infections successfully treated with vaginal acidification.
  • A. Aggarwal, R. Shier
  • Medicine
    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
  • 2008
TLDR
A process of vaginal acidification resulted in resolution of recalcitrant Trichomonas vaginalis in two patients who were successfully treated using vaginal Acidification.
Recalcitrant Infections Successfully Treated With Vaginal Acidification
TLDR
A process of vaginal acidification resulted in resolution of recalcitrant Trichomonas vaginalis in two patients who were successfully treated using vaginal Acidification.
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Arsenical pessaries in the treatment of metronidazole-resistant Trichomonas vaginalis
TLDR
A 23-year-old woman presented to this department with T. vaginalis which had originally been diagnosed and treated in Austria and failed to gain a lasting response from paromomycin cream or fenticonazole pessaries 1200mg daily, although the latter provided some symptomatic relief.
Managing vaginal trichomoniasis resistant to high-dose metronidazole therapy
TLDR
The experience in managing 3 patients in whom treatment of symptomatic trichomonal vaginitis with both conventional and high-dose metronidazole regimens was unsuccessful is reported, with results likely to become an increasing problem as the organism becomes refractory to the action of metronIDazole through adaptation to a microaerophilic or aerobic environment.
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It is now, however, indisputable that Tvaginalis stocks resistant to metronidazole do occur and that they are a main reason for "treatment failure".
Arsenical pessaries in the successful elimination of metronidazole-resistant Trichomonas vaginalis
TLDR
Available evidence suggests ivermectin is the current drug of choice for systemic strongyloidiasis in AIDS, given its effectiveness and ease of administration, and a parenteral antihelmintic is needed for those too unwell to swallow or absorb oral medication.
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A 36-year-old woman with symptomatic metronidazole-resistant trichomonal vaginitis for 10 years had a total of 22 courses of treatment with either metronIDazole or tinidazoles according to different schedules, and the former strain showed a definitely decreased sensitivity to ornidazol and tinidrazole.
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Assessment requires a considerable period of observation, and testing is complicated by the fact that many patients discontinue attendance when their symptoms are relieved, and that with outpatients there is no means of distinguishing between re-infection and relapse.
THE TREATMENT OF TRICHOMONAS VAGINITIS WITH ACETARSONE (STOVARSOL)
TLDR
Trichomonas vaginitis is intractable by the usual therapy of vaginal discharge; that fact is best evidenced by the large number of methods that have been recommended; in the last few years no less than six different modes were recommended.
In vitro drug susceptibility and doses of metronidazole required for cure in cases of refractory vaginal trichomoniasis.
TLDR
Of 31 cases that were re-treated and monitored, the highest average dose that failed to achieve a cure was 2.1 g of metronidazole/day given over an eight-day period; 27 (87%) of 31 cases were ultimately cured with an average dosage of 2.6 g of meetingtonidazoles given over a mean period of nine days.
Metronidazole resistant Trichomonas vaginalis in Brisbane
TLDR
A 54-year-old woman presented at the Brisbane Sexual Health Clinic with laboratory diagnosed trichomoniasis on the 12th day of a 14-day course of standard metronidazole treatment, confirmed by minimum inhibitory concentration testing.
Treatment failure in Trichomonas vaginalis infections in females. II. In-vitro estimation of the sensitivity of the organism to metronidazole.
TLDR
The current procedure demonstrates clearly that repeated treatment failure in patients without other complication is associated with enhanced resistance to metronidazole of T. vaginalis, and it may discriminate between T. vaginais infections that are likely to respond to higher dosage and those that are not.
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